The transcervical–transparotid corridor for management of parapharyngeal space neoplasms: strengths and limits in a bi-institutional retrospective series

Galli, Andrea; Giordano, Leone; Mattioli, Francesco; Serafini, Edoardo; Fermi, Matteo; Bramati, Chiara; Bussi, Mario

doi:10.1007/s00405-023-08256-7

Eur Arch Otorhinolaryngol

2023

DOI: 10.1007/s00405-023-08256-7

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The transcervical–transparotid corridor for management of parapharyngeal space neoplasms: strengths and limits in a bi-institutional retrospective series

Andrea Galli,

Leone Giordano,

Francesco Mattioli

et al.

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2024

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Cited by 3 publications

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Ultrasound-guided diagnosis on a parapharyngeal mass

Alessio,

Scarano,

Valentini

et al. 2024

J Ultrasound

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Masses in the parapharyngeal area are rare and often due to infectious phenomena arising from the oral cavity or pharynx which lead to abscess formation. Less frequently, the lesion can be neoplastic. Tumours of the parapharyngeal space are rare, accounting for less than 1% of all head and neck neoplasms. We report the case of a patient who came to our observation for mandibular pain. Multiparametric diagnostic imaging was done thus showing a parapharyngeal mass. An ultrasound guided biopsy was performed by a transcutaneous route with a high median approach at neck level, to characterize the mass in the right tonsillar region. The histological examination reported the final histological diagnosis of sarcomatoid carcinoma.

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Ultrasound-guided diagnosis on a parapharyngeal mass

Alessio,

Scarano,

Valentini

et al. 2024

J Ultrasound

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Squamous cell carcinoma metastatic to the lymph nodes of the parapharyngeal space: case series and systematic review

Fermi,

Botti,

Chiari

et al. 2024

Acta Otorhinolaryngol Ital

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Summary Objective Parapharyngeal space (PPS) is a rare and unusual site of head and neck squamous cell carcinoma (SCC) metastases. Treatment strategy for PPS metastases is still not well defined. This research aims to investigate the clinical implications and oncological outcomes of SCC metastases in PPS. Material and methods A systematic review was conducted according to PRISMA criteria. The authors considered only articles reporting the history and treatment of patients with PPS SCC metastases. A retrospective chart review was conducted in two tertiary referral academic centers collecting data of patients with diagnosis of PPS SCC metastases between 2010 and 2023 to study their outcome based on clinical presentation and treatment strategy. Results The retrospective chart review showed that the oropharynx was the most frequent primary tumour site. The advanced stage at the time of diagnosis was related to poorer survival and higher recurrence rates. A significant difference in 2-year overall survival in the subgroup of patients who experienced PPS metastases within the primary treatment and those who experienced PPS metastases as regional recurrence (66.7 vs 30.8%) was observed. Similar low survival rates were reported in the literature review with a mean overall and disease-free survival of 19.8 and 8.6 months, respectively. Conclusions PPS metastases are associated with a dismal prognosis, especially when diagnosed as regional recurrence after primary treatment, due to patients’ poor general conditions and difficulty of treatment.

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The Clinical and Surgical Characteristics of Parotid Tumors with Parapharyngeal Space Involvement—A Multicenter Experience of the Polish Salivary Network

Stodulski,

Mikaszewski,

Witkowski

et al. 2024

JCM

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Backgrounds/Objectives: Parotid gland tumors (PGTs) with parapharyngeal space (PPS) involvement have a specific clinical course and they can be a great challenge for surgeons, especially due to more difficult approaches and the risk of serious complications. The aim of this study is to present the characteristics of PGTs with PPS involvement. Methods: Retrospective, multicenter analysis of 1954 primary PGTs from 5 years (2017–2021) was performed. Comparative analysis was performed between groups with and without PPS involvement and included the following clinical and histopathological data: age, sex, place of residence, tumor size, FNAC result, percentage of malignant tumors, histological diagnosis, radicality of resection, and postoperative facial nerve (FN) dysfunction. Results: PPS involvement was found in 114 patients (5.83%). Secondary tumors affecting the deep lobe or the entire gland were predominant (46 and 60 cases, respectively). In a univariate analysis of tumors with and without PPS involvement, statistically significant differences were found in their size > 4 cm (12.97% vs. 37.72%), percentage of malignant tumors (7.12% vs. 17.55%), incidence of Warthin Tumors (WTs) (43.58% vs. 24.56%), percentage of R1 resection (5.53% vs. 12.50%), and rate of FN paresis (17.15% vs. 53.34%). Multivariate analysis showed that tumors with PPS involvement were statistically significantly characterized by larger size (tumors > 4 cm were 2.9 times more frequent), 2 times less frequent occurrence of WTs, and 1.6 times higher risk of FN paresis. Conclusion: PGTs with PPS involvement show certain clinical and histological differences and require more complex surgical accesses. Therefore, they cannot be treated as "ordinary" tumors occupying the deep lobe.

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The transcervical–transparotid corridor for management of parapharyngeal space neoplasms: strengths and limits in a bi-institutional retrospective series

Cited by 3 publications

References 25 publications

Ultrasound-guided diagnosis on a parapharyngeal mass

Ultrasound-guided diagnosis on a parapharyngeal mass

Squamous cell carcinoma metastatic to the lymph nodes of the parapharyngeal space: case series and systematic review

The Clinical and Surgical Characteristics of Parotid Tumors with Parapharyngeal Space Involvement—A Multicenter Experience of the Polish Salivary Network

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